Wang Yufan, Turkstani Heba, Alfaifi Afrah, Akintoye Sunday O
Department of Oral and Maxillofacial Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, China.
Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Diagnostics (Basel). 2024 Nov 27;14(23):2676. doi: 10.3390/diagnostics14232676.
Jaw osteoradionecrosis (ORN) is a major complication of head and neck cancer radiotherapy. Treatment complications account for most of the poor outcomes for head and neck cancers and the associated racial health disparities in cancer survivorship. The global incidence of jaw ORN is improving due to pre-radiotherapy patient preparations and improved head and neck cancer radiotherapy protocols. The diagnosis and management of jaw ORN are based on the patient's history and clinical presentation combined with radiological and histopathological tests. Evidence-based jaw ORN therapies focus on preventive, palliative, and surgical principles. However, new and innovative therapeutic approaches based on the cellular and molecular pathophysiological processes of jaw ORN and the jawbone's susceptibility to radiation bone damage are limited. The rationale for this narrative review is to highlight the current diagnostic approaches to jaw ORN and the pathophysiological basis for new therapeutic options for ORN.
颌骨放射性骨坏死（ORN）是头颈癌放疗的主要并发症。治疗并发症是头颈癌预后不良以及癌症幸存者中相关种族健康差异的主要原因。由于放疗前的患者准备工作以及头颈癌放疗方案的改进，全球颌骨ORN的发病率正在下降。颌骨ORN的诊断和管理基于患者的病史、临床表现，以及放射学和组织病理学检查。循证医学的颌骨ORN治疗侧重于预防、姑息和手术原则。然而，基于颌骨ORN的细胞和分子病理生理过程以及颌骨对放射性骨损伤易感性的新型创新治疗方法有限。本叙述性综述的目的是强调颌骨ORN的当前诊断方法以及ORN新治疗选择的病理生理基础。
